Why is there a gender gap in physician salaries?

Some research studies just contain too many revelations to not share with the world. The Health Affairs study on the pay gap between newly-trained male and female physicians is just such a study, demonstrating conclusively that:

1. The gender gap in physician salaries is not related to specialty choice or work hours. No matter where women are choosing to work (solo practice vs. hospital, city vs. rural), which specialty they choose to work in or how many patient care hours per week they sign up for, women physicians earn less than their male counterparts.  According to the lead author, the authors of this study “honestly tried everything we could to make [the trend] go away, but it wouldn’t.”


2. The gender gap has grown nearly five times from 1999 to 2008 from a $3,600 difference to a $16,819 difference. According to the authors, that $3600 difference (which takes into account all the confounding factors noted above) is not statistically significant (p=0.08), but the $16,819 difference is highly statistically significant (p < 0.001). This trend places doctors as the worst profession for women in terms of disparities in pay. Without these adjustments and just looking at a Population Survey from 2007, the New York Times reported that women doctors earn a whopping 40% less than their male colleagues. That is worse than every other profession the Times looked at. Yes, even lawyers. The only professions that come close are finance managers and clinical researchers.


3. Women choosing lower-paying primary care specialties have nothing to do with this trend because women have increasingly not been going into primary care specialties. In 1999 (when, remember, women did not have a statistically significant difference in wages from men), women were joining primary care fields at much higher rates than men (49% vs. 33%). In 2008, both women and men are joining primary care specialties at a rate of about 33%. Disregard the problem that this poses for the nation’s primary care shortage for a moment – this demonstrates that our nation’s women, who are becoming an increasingly large part of the health care workforce, are ambitiously seeking higher paying, more demanding specialties and still, are seeing an increased rather than a decreased gap in wages.

The authors claim that they cannot point to discrimination as a reason for this wage gap because:

  • the increase in wage gap from 1999-2008 occurred in primary care specialties (i.e. internal medicine, pediatrics and family medicine) and non-primary-care specialties.
  • they find it unlikely that discrimination could have increased so drastically in the ten years studied.
  • they lack sufficient information about the non-financial incentives that may be driving women to lower-paying positions.

That all may be true and clearly, this subject merits more careful and thorough study. However, for all those lady physicians and physicians-to-be out there wondering what to do about this trend, I invite them to watch the TED talk by Sheryl Sandberg on why we have so few women leaders and to think about how many of the factors she names applies to a female physicians.

Emily Lu is a medical student who blogs at Medicine for Change.

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